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Monitors & Equipment > Prodigy- Anesthesia Machine > Flashcards

Prodigy- Anesthesia Machine Flashcards

1
Q

What color cylinder is nitrogen?

CO2?

A

nitrogen = black

co2 = grey

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2
Q

The moment the psi of the n20 tank begins to drop, there is about how much nitrous oxide left in the tank?

A

400L

psi 745= 1590L

bc it’s liquid when full, it’s only once the liquid has been consumed, will the pressure drop below 745psi

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3
Q

Which kind of safety relief cylinder valve is a spring-loaded device that opens if the pressure within the tank exceeds a certain value?

A

Safety relief VALVE = spring loaded

frangible disk = metal disk that breaks when certain pressure is exceeded to allow the gas to vent
fusible plug = woods metal that will melt at higher temperatures

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4
Q

T/F- before installing a new o2 cylinder on your anesthesia machine, you should crack the valve open slightly for a second

A

True

doing this will clean away any grease, dust, or debris that would otherwise be released into the anesthesia machine

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5
Q

T/F- hospitals typically store oxygen in liquid form

A

True - at it’s critical temp of -160 degrees Celsius

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6
Q

With very high flow rates (15LPM), the majority of variable bypasss vaporizers will deliver (more/less) than the concentration set on the dial

what about low flow rates (<250mls/min)

A

less than for both

  • high flow rates - due to a failure of the carrier gas to become saturated with anesthetic vapor and an incomplete mixing in the vaporizing chamber

-low flor rates - there is not enough turbulence achieved to move the vapor molecules upward in the vaporizing chamber

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7
Q

theoretically speaking, if the carrier gas were rapidly changed from 100% o2 to 100% nitrous, the output from the vaporizing chamber would (increase/decrease) transiently

A

decrease

once the anesthetic liquid is completely saturated with nitrous oxide, vaporizer output somewhat increases, establishing a new steady state.

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8
Q

At high altitudes, a Tec 6 vaporizer will deliver a (higher/lower) partial pressure of desflurane

A

lower

think high altitude = low pressure , so youll need to provide MORE pressure on your end to establish the same partial pressure of the gas

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9
Q

when is a circle system considered a:
semi-open system vs semi-closed system vs closed

A

semi-open if the FGF rate is > minute ventilation
semi-closed if FGF < minute ventilation (pt must be rebreathing some of the exhaled gases)
closed - closed APL valve + FGFs match pts uptake of the gases

*closed circuit = rebreathing of exhaled gases

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10
Q

Someone asks you to explain the circle system

A

-the inspiratory limb has a one way valve that opens as the patient inhales
-pt exhales, inspiratory valve closes & expiratory valve in the expiratory limb opens
-pts exhaled tidal volume travels through the expiratory limb and into breathing bag
-then the exhaled gases travel through the CO2 absorbent prior to going back to the patient

the gas rebreathed by the patient is free of co2, but still has exhaled o2 and anesthetic

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11
Q

The amount of gas rebreathed by the patient is controlled by what

(circle system)

A

the FGF rate

  • if high rates, more exhaled gas will exit through the APL valve and go to the scavenger (less rebreathed)
  • if low rates, less exhaled gas exits the circuit and will be rebreathed by the patient
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12
Q

How come you should increase your fresh gas flows higher than the pts minute ventilation if you have a high inspired co2 due to exhausted absorbant? like why? how does that work?

A

bc increasing FGFs will direct more of the exhaled co2 to be directed towards the scavenging system via the APL valve

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13
Q

How do you prevent rebreathing with a Mapleson D circuit

A

Maples on D = fresh gas inlet close to the patient
so as the patient exhales, the FGF forces the exhaled gas toward the reservoir bag
this clears the circuit of exhaled gases on the next inhlation so the pt only inhales fresh gas

*FGF must be at least 2-3x minute ventilation for this to work

so if you determine ur pts minute ventilation is 6 - youd need to have 12L

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14
Q

The bain circuit is a modification of which Mapleson?

A

D

-uses a coaxial system in which the FGF hose lies within the corrugated tubing though which exhaled gas flows

the exhaled gas passes in the opposite direction of the fresh gas, establishing a countercurrent, helping to warm the inspired gas
-requires flows 1-2x the mv to prevent rebreathing

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15
Q

Where is the Wright Respirometer located

what does it do?

A

in the expiratory limb of the breathing circuit

it contians a rotating vein that spins in response to the force of air passing thru it
the # of times the vein spins is proportional to the tidal volume

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16
Q

why should you always have a fgf of at least 2LPM in older machines?

A

bc the wright respirometer that gives the reading for the exhaled tidal volume will underestimate the tidal volume if using less than 2LPM

in newer machines, the electronic respirometers are more accurate at low flow rates

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17
Q

70% of all circuit disconnects occur at the Y-piece. What other thing can trigger a low circuit-pressure alarm?

A

leaks in the ventilator pressure relief valve

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18
Q

If the anesthesia machine has a scavenging sytem that properly functions, trace concentrations of waste gas are reduced by how much?

A

90%

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19
Q

T/F- most scavenging mishaps result from user error

A

True

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20
Q

T/F: The Joint Commission mandates the use of active scavenging systems in the US

A

true

active = suction
can be open or closed
if closed- need postive and negative pressure relief valves

21
Q

3 purposes of the breathing bag

A
  1. it’s a resevior for exhaled gases
  2. it provides a visual means of assessing ventilation
  3. provides a means for manual ventilation
22
Q

When the Bag/vent switch is turned to vent- what components are removed form the anesthesia circuit in a gas-driven vent? (2)

A

the APL valve and the reservoir bag

23
Q

how can bellows be a useful indicator of the degree of neuromuscular blockade?

A

the diaphrgam recovers before the peripheral muscles, so as a patients respiratory effort begins to increase, movement in the bellows may be noted between ventilator cycles

think this is kinda like the movement between the waveform on the vent

24
Q

Which would be more effective at preventing the transmission of the hepatitis C virus - hygroscopic or hydrophobic HME’s

A

hydrophobic

think fearing water, doesnt like water, water is breading ground for bacteria, so no water, no viruses - idk

25
Q

when (hydroscopic/hydrophobic) HEM’s becoem wet, they may lose their ability to filter airborne pathogens and airway resistance may increase substantially

A

hydroscopic

26
Q

An HME (should/should not) bue used with a heated humidifer

why or why not

A

should NOT

the combination of the 2 can produce a daengerous resistance to airflow

27
Q

soda lime absorbent contains primarily what?

A

calcium hydroxide

and a smaller amount of sodium hydroxide

28
Q

max amount of CO2 that can be absorbed by soda lime?

A

26L of CO2 per 100g absorbant

29
Q

Why do you want to gently shake the co2 canister prior to use ?

A

to prevent channeling

occurs when gases flow through passages of lower resistane in the co2 cannister

30
Q

The anesthesia machine fail-safe mechanism will
A. decrease the nitrous oxide concentration to maintain an FiO2 of 25%
B. interrupt nitrous oxide flow if the oxygen supply pressure drops
C. detect the delivery of a hypoxic gas mixture at the common gas outlet
D. sound an alarm if the FiO2 drops below 25%

A

B

31
Q

You are preparing to initiate mechanical ventilation for a patient with pulmonary fibrosis. The tidal volume is 700 mL, the respiratory rate is 10/min, and the I:E ratio is 1:2. Your primary concern in this patient with the use of volume-controlled ventilation is
A. increased peak airway pressures
B. a prolonged inspiratory time
C. sudden drops in the respiratory rate
D. a prolonged expiratory time

A

not D-A

32
Q

The oxygen proportioning system on an anesthesia machine limits the FiO2 when using nitrous oxide to a minimum of
A. 21%
B. 33%
C. 30%
D. 25%

A

D

33
Q

Which of the following statements comparing hydrophobic and hygroscopic heat and moisture exchangers (HMEs) is correct?
A. Hygroscopic HMEs are more effective at preventing the transmission of the hepatitic C virus
B. Hydrophobic HMEs function better at high ambient temperatures than do hygroscopic HMEs
C. Hydrophobic HMEs are more effective at conserving heat and moisture
D. Hygroscopic HMEs exert a greater airway resistance than hydrophobic HMEs when wet

A

D

34
Q

Which bellows configuration is considered safer?
A. Ascending
B. Both ascending and standing
C. Standing bellows
D. Descending

A

B

35
Q

Which ventilation mode carries the greatest potential for barotrauma due to breath-stacking?
A. Intermittent mandatory ventilation
B. Assist-controlled ventilation
C. Synchronized intermittent mandatory ventilation
D. Pressure support ventilation

A

A

36
Q

What device on an anesthesia machine is designed to prevent the administration of a hypoxic mixture of nitrous oxide?
A. The hanger yoke check valve
B. The oxygen proportioning system
C. The common gas outlet check valve
D. The vaporizer dial

A

B

37
Q

All newly manufactured anesthesia machines are supplied with _____-reservoir scavenging interface systems with a(n) _____ disposal system.
A. open, passive
B. closed, active
C. closed, passive
D. open, active

A

D

38
Q

Which of the following is more likely to produce the pumping effect in an anesthetic vaporizer?
A. Using the oxygen flush valve
B. Having a full vaporizer fill chamber
C. Using high vaporizer dial settings
D. Using low respiratory rates

A

A

39
Q

An active, heated humidifier is typically set to heat the inspiratory gas to between
A. 24 and 28 degrees Celsius
B. 34 and 40 degrees Celsius
C. 30 and 32 degrees Celsius
D. 20 and 23 degrees Celsius

A

Not C

40
Q

Which is the only safety device that evaluates the integrity of the low-pressure circuit in an ongoing fashion?
A. Oxygen supply failure
B. Proportioning system
C. Oxygen analyzer
D. Fail-safe valve

A

Not D

41
Q

What component of the hanger yoke prevents the cross-filling of gas from one cylinder to another?
A. The check valve
B. The transfill limiter
C. The T-handle
D. The pin index safety system

A

A

42
Q

According to the American Society for Testing and Materials (ASTM), the maximum pressure a standard 1.5 liter breathing bag can exert if expanded as much as 4 times its normal size is
A. 25 cm H2O
B. 50 cm H2O
C. 75 cm H2O
D. 100 cm H2O

A

B

43
Q

On what principle do the mechanical flowmeters on anesthesia machines function?
A. The inverse square principle
B. Flow past a resistance is proportional to the pressure
C. The Coanda effect
D. The Venturi effect

A

D

44
Q

A healthy, 70 kg adult patient under general anesthesia with an LMA exhibits spontaneous respirations with a rate of 12/min and a tidal volume of 150 mL. What ventilation modality would be the most appropriate for this patient?
A. Volume-controlled ventilation
B. Intermittent mandatory ventilation
C. PEEP of +5 cm H2O
D. Pressure support ventilation

A

D

45
Q

The gases from the anesthesia flowmeters are first mixed in the
A. common gas outlet
B. scavenging interface
C. common manifold
D. vaporizer

A

C

46
Q

The hanger-yoke assembly on the anesthesia machine is responsible for which of the following?
A. Preventing the inadvertent delivery of a hypoxic gas mixture
B. Providing uni-directional gas flow
C. Storing a backup supply of volatile anesthetic
D. Detecting leaks in the cylinder connections

A

B

47
Q

The unidirectional valves in an anesthesia circuit
A. do not function during spontaneous ventilation
B. decrease the deadspace in the circuit
C. do not function during mechanical ventilation
D. add approximately 5 cm H2O of PEEP

A

B

48
Q

Which of the following statements regarding the Bain circuit is true?
A. It utilizes a countercurrent exchange to warm the fresh gas
B. The exhalation tubing should provide a volume larger than the tidal volume to prevent rebreathing
C. It is a modification of the Mapleson A circuit
D. It requires a fresh gas flow equal to three times the minute ventilation

A

A

49
Q

Which statement reflects an accurate understanding of the flowmeter tubes on an anesthesia machine?
A. The ball or bobbin is more likely to stick at high flows
B. the rotameter tubes are accurate in the vertical or horizontal positions
C. Flow should be read at the middle of a bobbin
D. A ball is less likely to stick in the presence of dirt

A

D

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